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Tobacco Cessation Program helps patients quit, for better results from cancer treatment

Tobacco use is the leading preventable cause of cancer and cancer deaths, according to the Centers for Disease Control and Prevention (CDC). Cigarette smoking is related to higher cancer rates, worse cancer-related treatment results, and lower quality of life. Research also indicates that tobacco use makes cancer symptoms worse.

Most people know that quitting tobacco can improve their lives, but the stress of cancer can make that even more difficult. For those who may not realize the benefits of quitting after a cancer diagnosis, the Tobacco Cessation Program at the O’Neal Comprehensive Cancer Center at UAB offers a clear, research-based path for kicking the habit.

“It’s rare that I get a patient who has never tried quitting,” said Megan Princewill, a tobacco treatment specialist for the Tobacco Cessation Program. “If this was easy, I would not have a job, but if it was impossible, I also would not have a job.”

Personalized approach

Tobacco is often used as a coping mechanism for stress, and a cancer diagnosis – even one that tobacco use contributed to – can make the dependency even stronger. Princewill helps patients find the right personalized approach to quitting and use this approach again in the future if necessary.

The Tobacco Cessation Program helps patients understand their dependency and the benefits of quitting, set realistic goals, find the right combination of treatments, and remain tobacco-free throughout cancer survivorship. The typical program includes 4-6 sessions, which may be held weekly or at longer intervals. For the convenience of patients, Princewill conducts most of her sessions via online telehealth appointments.

Recognizing triggers

Princewill says there are physical and psychological aspects to tobacco dependence. Patients often underestimate the power of deeply engrained habits involving where and when they smoke, without giving much thought to “needing” the tobacco. So, her first step is to talk to patients about where they smoke or use tobacco automatically (i.e. when first getting in the car), then she helps them find a way to make it slightly more difficult to use it in that place. In many cases, she says, this helps patients limit their tobacco use to one place and recognize times when they really didn’t need it.

The patient may set short-term goals, such as reducing the number of cigarettes smoked per day. They recognize days that they fall short or tend to smoke more, so that their quitting strategy can account for those triggers.

Setting a quit date

Princewill works with patients to set a quit date, which can be based on a scheduled treatment or another time that is significant or reasonable to them. She coaches patients to replace cravings and triggers with healthy stress management skills. For many patients, quitting is a process of months, and relapses are a normal part of the process. She says it takes some people up to seven tries to quit for good.

Medicinal and behavioral approaches

No matter the type of cancer or the treatment, tobacco hurts treatment outcomes from day one. When you already have cancer, you need every advantage to quit fast. Therefore, along with behavioral therapy, the Tobacco Cessation Program offers patients medicines that make quitting easier. These include nicotine replacement therapies (NRT) such as the transdermal patch and prescription medications like Chantix to reduce withdrawal symptoms.

Involving loved ones

Princewill encourages patients to involve loved ones in their sessions, especially those who use tobacco and are also ready to quit. “Couples who hold each other accountable often quit faster than individuals,” she said.

Never give up

Part of quitting is adopting a mentality to learn from setbacks and not feel defeated by them, Princewill said. Patients are scheduled for one-month, three-month, six-month, and yearly follow-up visits after quitting. “If five years pass and they have a relapse, I’m a call away,” she said.

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